Provider Demographics
NPI:1265088967
Name:TATE, ALLISON NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:NICOLE
Last Name:TATE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:NICOLE
Other - Last Name:HOLLEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38 CHESTNUT MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-1407
Mailing Address - Country:US
Mailing Address - Phone:281-639-3888
Mailing Address - Fax:
Practice Address - Street 1:17521 ST LUKES WAY STE 190
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8040
Practice Address - Country:US
Practice Address - Phone:936-321-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-18
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily